OBJECTIVE To investigate the effects of intra-articular injection of sodium hyaluronate in post-operation treatment of the knee. METHODS From January 1998 to February 2001, 4 ml of sodium hyaluronate injection was injected into the knee joint of the 134 cases at the end of arthroscope operation, or the 91 cases undergoing open operation of the knee at the time when the drain tube was removed (treatment group). Five days after operation, the hydrarthrosis was removed and 2 ml of sodium hyaluronate was injected into the knee joint. According to the patient’s condition, injection of sodium hyaluronate was performed once a week for several weeks. Clinical evaluation was made by evaluating pain visual analog scale (VAS) and painless range of movement (ROM) of the joint at every definite point of time. The 85 patients in control group used nothing at the same time. RESULTS The VAS score of patients in the treatment group was significant lower than that of the control group. The period to the maximal painless ROM of the joint was 6 days in the treatment group after open operation, while 9 days in the control group. CONCLUSION Sodium hyaluronate appears effective in relieving post-operation pain of the knee joint.
Objective To investigate the effects of sodium hyaluronate solution on the proliferation and differentiation of myoblasts. Methods The 3rd subculture myoblasts from muscle of infant SD rat were cultured in four growth media, in which the concentrations of sodium hyaluronate were 0.05% (group A) , 0.1%( group B), 0.2% (group C)and 0 (group D, control group), respectively. The proliferation rate of myoblasts in each medium was observed through growth curves by means of count and MTT. At the same time, the subculture myoblasts were cultured in differentiated media in which the concentrations of sodium hyaluronate were 0 and 0.1%. The capacity of fusion of myoblasts was compared between two kinds of differentiated media. Results There were the nearly same proliferation curse in Groups A, B and C: increasing by logarithm at 2 days and reaching peak value at 4 days. The myoblasts in Group D increased slowly: increasing by logarithm at 3 days, doubling at 5 days and reaching peak value at 6 days. MTT has the similar curse to counting. The myoblast proliferation of Group B was more than that of the other groups. The peak value of myoblast fusion was 35% at 6 days in common differentiated media; slowly reached 11.7% at 7 days in the differentiated media in which the concentrations of sodiumhyaluronate was 0.1%.Conclusion Sodium hyaluronate at certain concentration can be a decent media for myoblasts, it can accelerate proliferation and differentiation of myoblasts.
OBJECTIVE To assess the effect of sodium hyaluronate (HA) for degenerative disorders of the temporomandibular joint (TMJ). METHODS A prospective randomized controlled clinical trial was conducted. The experimental group received injections in the upper compartments of the involved TMJs with 1% HA 6 mg, whereas the control group received prednisolone (PS) 12.5 mg once a week. Three to four injections were as one course. Before and one week after the treatment courses, clinical symptoms, amount of interleukin-6 (IL-6) and total protein of synovial fluid were measured and compared. RESULTS Sixty-seven patients were included and 4 out of them were dropped out. There were 12 males and 51 females, among them, 14 cases with synovitis, 21 with anterior disc displacement without reduction and 28 with osteoarthritis of the TMJ. Thirty-five patients allocated in HA group and 28 in PS group. Both drugs could relieve the clinical symptoms of TMJ degenerative disorders. In HA group, marked improvement rate was 51.43% and failure rate was 2.86%, whereas marked improvement rate 39.29% and failure rate 17.86% in PS group. The declined levels of IL-6 in synovial fluid was notably greater in HA group than those in PS group. CONCLUSIONIntra-articular injection of HA is effective and safe to treat TMJ degenerative disorders with mild adverse reactions, better in terms of effective rate and declined level of IL-6 than PS.
Objective To explore effective substances and methods for prevention of peridural adhesion. Methods Laminectomy was performed on the 5th lumbar segment in 64 rabbits, which were equally divided into 4 groups. The duramater (12 mm×6 mm) was exposed. The exposed duramater was left uncovered in Group A; the exposed dura mater was covered with sodium hyaluronate jel (high molecular weight, 1 ml) in Group B; the lamina repair was performed with the autologous spinous process in Group C; the lamina repair was performed with the sodium hyaluronate jel filling and the autologous spinousprocess in Group D. The specimens were observed grossly and histologically at 2, 4, 6 and 8 weeks postoperatively. The computed imaging analysis on the epidural adhesion was also performed at 6 weeks postoperatively. Results ①The gross anatomical evaluation: Severe peridural adhesion was formed in Group A, less adhesion formed in Groups B and C, but no obvious adhesion formed in Group D. ②The area percentage of the epidural scar: The area percentage ofthe epidural scar was 15.89%±1.88% and 13.94%±1.89% in Groups C and D respectively, which were significantly lower than those in Groups A and B (22.66%±2.89% and 20.70%±2.82%,Plt;0.05). ③The density of epidural scar: Thedensity of the epidural scars were 42.03%±7.36% and 36.50%±9.08% in Groups B and D, which were significantly lower than those in Groups A and C (63.73%±6.06% and 52.11%±4.10%，Plt;0.05). Conclusion The high molecular weight sodium hyaluronate jel filling combined with the lamina repair using the autologous spinous process has the best preventive effect on the peridural adhesion after laminectomy.
OBJECTIVE To investigate the therapeutic effect of percutaneous lumbar discectomy (PLD) combined with sodium hyaluronate (SH) injection in the treatment of lumbar intervertebral disc herniation. METHODS Forty-eight patients suffered from lumbar disc herniation were divided into two groups and treated by PLD combined with SH injection into epidural cavity (treatment group) or single PLD (control group) respectively. All patients were followed up for 24 months. The therapeutic effects in both groups were assessed and compared according to Macnab’s criterion. RESULTS The patients in the treatment group got much more significant improvement than those in the control group, with shorter therapeutic course and more safety. CONCLUSION PLD combined with SH injection into epidural cavity is more effective and safety in the treatment of lumbar disc herniation than of pure PLD.
Objective To explore the relationship of the limited resource of the autologous bone marrow mesenchymal stem cells (MSCs) in articularcavity to the treatment results of full-thickness articular cartilage defect, and to investigate whether the extrogenous sodium hyaluronate(SH) promotes the migration of MSCs cultured in vitro tothe articular defect in vivo. Methods Sixty-six Japan rabbits were made the model of the full-thickness articular cartilage defect (5 mm width and 4 mm depth).The autologous MSCs were extracted from the rabbit femur, cultured in vitro, labeledby Brdu, and injected into the injured articular cavity with or without SH. Theexperiment was divided into 4 groups; group A (MSCs and SH, n=15); group B (MSCs, n=15); group C (SH, n=18); and group D (non-treatment, n=18). The morphologic observation was made by HE staining, Mallory staining and immunohistochemical staining after 5 weeks, 8 weeks and 12 weeks of operation. Results There were significant differences in the thickness of repairing tissue between group A and group B(Plt;0.01); but there were no significant differences between group A and group C, and between group B and group D(P＞0.05). Thehistological observation showed that the main repairing tissue was fibrocartilage in group A and fiber tissue in group B. Conclusion MSCs cultured in vitro and injected into the articular cavity can not improve the treatment results of the articular cartilage defect. Extrogenous SH has effect on repairing cartilage defect. The extrogenous SH has no effect on the chemotaxis of the MSCs, and on the collection of MSCs into the joint defect.
Objective To analyze and compare the domestic quality standard and foreign quality standard of sodium hyaluronate (HA), and to expatiate on the critical process monitoring parameters. Methods Different quality standards of HA were compared by translating and sorting, and some experimental data were analyzed as well as the manufacturing practice was elaborated. Results Differences exist in raw materials standard or specifications of products between domestic and foreign, but the basic control points are concordant. Conclusion The company should set up reasonable and controllable quality standard based on quality requirements and related process characteristics so as to assure the safety and effectiveness of the clinical application.
OBJECTIVE To evaluate the effects of sodium hyaluronate on adhesion prevention after flexor tendon surgery. METHODS In 47 cases with the flexor tendon surgery, two kinds of sodium hyaluronate jelly preparations were injected into the tendon sheath before suture. Preparation I (20 mg/2 ml) was for group A (17 patients) and preparation II (20 mg/2 ml) was for group B (16 patients). The control group (group C, 14 patients) were treated in the same way except injection of sodium hyaluronate. The functions of afflicted fingers including flexibility, pain and swelling were measured immediately, at the first, second and the third month after operation. RESULTS All 47 patients were followed up 1 to 3 months. 64.71% patients in group A and 68.75% in group B showed significant improvement. There were significant difference compared with group C (P lt; 0.05). There were no significant adverse reactions were observed in all groups. CONCLUSION Two sodium hyaluronate preparations have effects in adhesion prevention after flexor tendon surgery with safety and expedience.
OBJECTIVE To assess the treatment effect of sodium hyaluronate (HA) on experimental temporomandibular joint (TMJ) osteoarthritis of rabbits in comparison with prednisolone (PS). METHODS The upper compartments of both TMJs of 12 Japanese White Ear Rabbits were injected with 0.2 ml of 1.6% papain, 3 days after the right TMJs were injected again with same amount of papain to induce osteoarthritis with different severity levels. Except 1 rabbit was died accidentally. After one week from final injection of papain, the upper compartments of both TMJs of 6 rabbits were injected with HA 1.3 mg, 5 rabbits with PS 1.6 mg weekly for 4 times. At 3, 5 and 7 weeks after the final injection, the rabbits were sacrificed and the TMJs were pathologically examined. RESULTS The TMJs receiving PS showed predominant structural disorganization, and the right TMJs had much severe pathology. The manifestations were fibrillation, thinner or flaking of the articular cartilage of the temporal part of the joint, and the articular surface was covered with fibrous tissue. Whereas the TMJs receiving HA injections demonstrated limited changes of cartilage, less fibrillation, only local loss of cartilage on outside layer of the surface. In vicinity of the defect area, cluster of the chondrocytes appeared. Pathological scores of the TMJs receiving HA were significantly less than those of the TMJs revieving PS. CONCLUSION The results suggest that hyaluronate have effect of cartilaginous reparation and protection for the osteoarthritis of rabbit. While prednisolone has no help or worsened for articular cartilage reparation.
Objective To determine the effectiveness of sodium hyaluronate (SHA) in preventing intraperitoneal (IP) adhesion. Methods Thirty-eight rats were randomly divided into A,B,C groups, normal saline, 6% Dextran-40 or SHA were applied on the present serosal injury respectively, during operation. Biopsy was taken on the 14th postoperative day.Results There were statistically significant differences in the extent of adhesion among three groups (Ｐ＜0.01). Mild inflammatory changes and less fibrous proliferation were found in group C by microscopy and decreased production of collagen (by fibroblast) and active mesothelial cells proliferation were observed in group C under electron microscope. Conclusion SHA appeares to reduce the extent of postoperative IP adhesion, which is more satisfactory than Dextran-40.